The urgent need for medicines to save lives, families and the fabric of our communities today impels a group of applicants (which includes the Treatment Action Campaign, unions and doctors) to launch a complaint with the Competition Commission in South Africa against two major international drug companies, GlaxoSmithKline (GSK) and Boehringer Ingelheim (BI). The complaint charges these corporations with excessive pricing in respect of several key drugs for the treatment of AIDS. The drugs are: RetrovirAE (zidovudine or AZT), 3TCAE (lamivudine), CombivirAE (AZT/lamivudine) and ViramuneAE (nevirapine).
This is a novel step that engages South Africa's sophisticated competition regulatory system in an effort to secure justice and rationality in drug pricing in the AIDS epidemic. Tens of thousands of people in our country are dying every year because of excessive prices for these medicines and because of government's lack of determined action to reduce the prices.
People living with HIV/AIDS, our doctors and nurses, the Treatment Action Campaign (TAC), the Congress of South African Trade Unions (Cosatu) and the Chemical Energy Paper, Printing, Wood and Allied Workers Union (CEPPAWU) have decided to act jointly against continued, unjust and insupportable drug company profiteering. South Africa needs affordable medicines now.
According to the World Health Organisation, the most commonly recommended triple drug therapy for HIV/AIDS is the combination of CombivirAE AZT/lamivudine) and ViramuneAE (nevirapine). We are placing the following powerful evidence before the Competition Commission: a month's supply of this treatment regimen at retail prices costs R1176.00 from Glaxo and Boehringer. By contrasts, the best-priced generic internationally cost R276.00 per month. The stark fact is that for the cost of one treatment from the brand name companies four people with AIDS can be treated on generics. We have additional evidence of excessive pricing for individual drugs.
Excessive pricing or profiteering by GlaxoSmithKline and Boehringer Ingelheim is directly responsible for premature, predictable and avoidable deaths of people living with HIV/AIDS, both children and adults.
For nearly four years, TAC and our allies have campaigned globally for drug companies to issue unconditional voluntary licences, against a royalty payable to the corporations of 4-5%, to allow generic competition and the lowest prices. This is a rational, fair and life-saving proposal. The drug companies have ignored it. Now we are asking the Competition Commission to investigate the complaint and to refer it to the Competition Tribunal.
We seek the following relief:
An order that GlaxoSmithKline and Boehringer Ingelheim stop the excessive pricing practices; A declaration that the excessive pricing conduct is a prohibited practice for purposes of damages claims by all persons who can establish that they have suffered loss or damage as a result of the prohibitive practice concerned; and An administrative penalty against the companies.
We are taking this action to ensure that:
The right to life is placed before profiteering; People living with HIV/AIDS who work can afford to buy medicines to save their lives; Children living with HIV/AIDS will get access to antiretroviral medicines; Medical schemes can afford to treat people living with HIV/AIDS without going bankrupt; Employers can treat their workers on a sustainable basis; and that Government shakes off the denialist paralysis and develop a national treatment plan.
We call on all people in South Africa and across the world to support this action taken by people living with HIV/AIDS, health care professionals, TAC, Cosatu and Ceppawu. We urge everyone to call on all drug companies to immediately issue unconditional voluntary licences for antiretroviral medicines to save the lives of millions in our country and across the world.
* Note: Equinet jointly with Oxfam GB will shortly be putting out a call for applicants for a grant looking at equity issues in relation to HIV/AIDS and particularly treatment access.
1. Editorial
Thumida Maistry will be leaving Equinet as at the end of October 2002. Equinet is grateful to Thumida for her energetic commitment to the network. She has been working for the past three months on background work for an advocacy plan for Equinet that will be more substantively taken up in 2003. Programme co-ordination will continue to managed through TARSC as always and communications should be directed to admin@equinetafrica.org.
2. Equity in Health
Treatment activists from 21 African countries have formed a movement to promote quality care and support for all Africans living with HIV/AIDS. At a meeting in Cape Town, South Africa recently over 70 activists gathered to inaugurate the Pan-African HIV/AIDS Treatment Access Movement (PHATAM). The organisation was founded by two of the world's leading activists, Zackie Achmat of the Treatment Action Campaign (TAC), South Africa and Milly Katana of the Health Rights Action Group in Uganda. PHATAM is dedicated to mobilising African communities, political leaders and all sectors of society to ensure that access to antiretroviral treatment is a fundamental part of comprehensive care for all peopie with HIV/AIDS.
One in four new HIV infections in the UK may be resistant to current drug treatments, say experts. The annual conference of the Public Health Laboratory Service heard that the growing problem of resistance made measures to prevent initial HIV infection ever more important.
Richard Feachem, director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said that the fund will run out of money by the middle of next year unless it receives new donations, the Boston Globe reports. The fund has received $2.1 billion in pledges but has collected only $500 million.
Two more southern African countries, Malawi and Mozambique, have followed Zimbabwe's example and have accepted genetically modified (GM) food as starvation takes its toll in the region. President Mugabe, who earlier this year had said he would not allow "his people" to consume GM food, as it was feared to cause negative reactions in human beings, made a U-turn last month by announcing that the country would begin consuming GMs because of the prevalent food crisis.
The Dutch government is to recall a large batch of AIDS drugs which were sold at cut-price rates in Africa and illegally re-exported to the lucrative European market. Dutch officials said that more than 35,000 packets of pills with a market value of close to 15m Euros had been re-sold in the Netherlands and Germany, where a similar investigation is being conducted. Two types of Aids drugs were involved, both made byGlaxoSmithKline.
Malaria scythes a similarly deadly path across much of Africa, sparing only higher elevation areas that aren't hot enough or countries like South Africa and Zimbabwe, where it has been brought under control. The continent's annual malaria death toll is well over a million and could be as high as two million, with children five and under making up 90 per cent. So you might expect people like Graham Reid - a British tropical medicine expert who manages a Canadian-financed health project in two rural districts of Tanzania - to be very excited about the multi-million-dollar deciphering of the genetic codes for the most prevalent malaria mosquito and the deadliest malaria parasite, dual breakthroughs announced this week by huge teams involving 160 researchers in 10 countries. Experts generally agree that these gene catalogues should accelerate development of affordable malaria vaccines, improved drugs to treat the disease, more effective chemicals to repel the biting mosquitoes and a range of techniques to neutralize mosquitoes that carry the parasite, including designer insecticides. Instead Graham is thinking about $3 bednets and how many lives these could save while the malaria genome breakthroughs struggle through an expected decade-long development process before producing the promised new anti-malaria weapons.
Urgent action by Government can save 3 million lives of people living with HIV/AIDS by 2015, reduce the number of orphans and prevent new infections. New research demonstrates the enormous social and economic costs our country will face if government does not lead civil society and the private sector in the use of antiretroviral therapy. The Treatment Action Campaign's (TAC) call for a national treatment plan by government with clear budgets and time-frames is the only chance this government has to avoid a social catastrophe.
Four months after the first warnings of an imminent humanitarian catastrophe in Southern Africa, several hundred thousand people may die because funds to provide basic relief for those who suffer have not been raised. The World Health Organization (WHO) has urged international partners meeting at its Geneva headquarters to do more to help Southern African nations stem a tide of death and disease from the humanitarian crisis in the region.
Joint U.N. Program on HIV/AIDS (UNAIDS) Executive Director Peter Piot of Belgium is one of the leading candidates to head the World Health Organization when Director General Gro Harlem Brundtland steps down in July, the Belgian daily De Standaard has reported.
Human rights groups this week condemned legal action against a Zambian legislator who alleged people had died of starvation in his constituency, thereby contradicting government assurances of no hunger-related deaths in the drought-hit countryside. Vitalis Mooya, the member of parliament (MP) for Moomba, about 240 km south of the capital Lusaka, faces charges of making false statements aimed at causing public alarm, a jailable offence under Zambian law.
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3. Human Resources
Do African adolescents know enough about AIDS to protect themselves against infection? What is the best way to educate them about the risks of HIV? A report from Population Services International evaluates a peer-led HIV prevention programme in a secondary school in Zambia.
A group of American researchers now suggest that the community in which one lives is as important as an individual's behavior in determining the risk of HIV infection. "The risk of individual behavior is enhanced or lessened by the type of place in which it takes place," said study lead author Dr. Shelah S. Bloom of the University of North Carolina at Chapel Hill. Bloom and her colleagues reported their findings in Sexually Transmitted Infections (2002;78:261-266). The researchers analyzed data from surveys conducted in a rural northern Tanzanian region with about 20,000 inhabitants between 1994 and 1997.
AT least 30 percent of all school teachers countrywide are HIV-positive, according to Mr Saul Murimba of the Southern Africa Consortium for Monitoring Educational Quality. He told participants at a two-day workshop on management of HIV/Aids at the education district level that the teachers would eventually succumb to the pandemic.
4. Public-Private Mix
Effective treatment of curable sexually transmitted infections (STIs) is one of the few strategies available to reduce the spread of HIV in sub-Saharan Africa. Many people with STIs seek treatment from private practitioners. Why are patients turning to the private sector for help? Do they receive adequate care?
5. Resource allocation and health financing
This paper summarises a review undertaken by the International HIV/AIDS Alliance (the Alliance) in August and September 2002, assessing the participation of HIV non-governmental organisations (NGOs) in 6 country-level processes of the Global Fund for AIDS, TB and Malaria. These
processes include the Country Coordinated Mechanism (CCM), the Country Coordinated Proposal (CCP) and all other Global Fund related activities and consultations. The review was undertaken on the basis of anonymity, so all quotes and experiences are not attributed to specific individuals or countries. Recommendations are made based on these NGO experiences and from broader Alliance experience in providing technical and financial support to NGOs and community-based organisations in over 40 developing countries.
Dr. Roland Msiska, Project Director for UNOPS executed UNDP Regional Project on HIV and Development in sub-Saharan Africa-Pretoria, South Africa.
This paper attempts to contribute to potential ways of ensuring that the momentum that has been generated by UNGASS and the creation of the GFATM for an effective well coordinated response to HIV, especially in Africa, is increased and sustained for at least 20 years. In order to achieve this, I am suggesting that we respond to the following questions: (a). What is the current situation of HIV/AIDS and what are the implications for achieving the global millennium goals? (b). What are the key areas of focus for sustaining the momentum of UNGASS implementation at global, regional and national levels? (c). How can we ensure that the GFATM facilitates the implementation of UNGASS at global, regional and national levels? (d). How can we ensure that wealthy nations facilitate countries in the sub-Saharan Africa to meet UNGASS commitments?
6. Governance and participation in health
Edited by: Sakiko Fukuda-Parr, Carlos Lopes and Khalid Malik, 2002.
The book contains a range of views from practitioners,academics and policy-makers about what has gone right with technical cooperation in recent years, what has gone wrong,and how to do it better and perhaps very differently.In so doing,it focuses on the questions of indigenous capacity, ownership, civic engagement and new possibilities for knowledge-sharing, for which the revolution in information and communications technologies offers ample opportunities.
7. Monitoring equity and research policy
A series of recommendations focuses on improving ethics review of protocols, reforming the informed consent process, improving access to information by participants and those responsible for review and monitoring of protocols,enhancing safety monitoring, compensating those who are harmed as a result of their participation in research; and developing a standard of quality.
The Alliance for Health Policy and Systems research in Collaboration with the Council on health Research for Development, Global Forum for Health Research and INCLEN Trust have just published new training modules to support strategies aiming to increase the impact of health research on policy, programmes and practice. The modules focus on practical experience and best practices regarding:priority-setting in health research (6 training units); knowledge management (5 training units); advocacy and leadership (5 training units). Those interested in increasing the impact of health research will benefit from the modules. In particular, research managers, policy analysts within ministries of health and research and continuing education officers may find that training in these subject areas will be a valuable investment. To download the modules visit the Alliance Web site. In addition,
The Alliance in collaboration with regional HPSR networks is preparing a series of research to policy workshops with the aim of strengthening capacity to demand high quality, timely and relevant HPSR. This effort will be supported with the training materials just published. Indra Pathmanathan will be leading this effort and will rely on her vast experience with HPSR capacity strengthening and policy development. Workshops will be celebrated between November 2002 and March 2003. Grants will be available for selected participants.
8. Useful Resources
The CHANGE Project develops and applies practical solutions to behaviour change problems relevant to health and nutrition through collaborative partnerships with local governments, private voluntary agencies, non-governmental organisations and USAID co-operating agencies. Examples of problems that CHANGE focuses on include the "deadly delay" in seeking
treatment for sick children or women with complications in childbirth.
The International Organisation for Migration (IOM) in partnership with the Swedish International Development Cooperation Agency (SIDA) and the Centre for AIDS Development, Research and Evaluation (CADRE) have set up a searchable web-based bibliography database on mobile populations and HIV/AIDS. CADRE is a South African non-profit organisation working in the area of HIV/AIDS social research, project development and communications. CADRE is hosting the database on their website: http://www.cadre.org.za Click on bibliographies in the menu, and put a tick mark left of the database HIV/AIDS and Mobile Populations in Southern Africa and search. Some search results have hyperlinks to electronic documents and other websites. If you have a new entry please email CADRE, they will update the database regularly.
The International HIV/AIDS Alliance has produced an electronic library of resources about NGO/CBO support that have been collated from a wide range of organisations, based on the many viable approaches to NGO/CBO support provision. The toolkit will be of interest to organisations that
fund and/or provide technical support to local NGOs and CBOs. These resources are accessible on CD-ROM as well as on the website.
The South African Medical Research Council (MRC) in collaboration with several partners is in the process of establishing an Internet information portal on HIV/AIDS for Southern Africa. The portal will provide a unique knowledge resource to facilitate collaboration and knowledge sharing among institutions and individuals in the prevention of HIV/AIDS in Southern Africa.
9. Jobs and Announcements
Two years ago, African leaders pledged to drop import taxes on treated mosquito nets in an attempt to reduce the continents' enormous malaria epidemic. On the second anniversary of their meeting, fewer than half have kept that promise. In a declaration made in Abuja, Nigeria on 25 April 2000, Africa's leaders pledged to reduce the cost of protecting mothers and their children from mosquitoes. Of the one million people who die from malaria in Africa each year; the majority are children and pregnant women. According to the Massive Effort, a global initiative that is mobilizing society to fight AIDS, tuberculosis and malaria, 26 countries still have not removed taxes and tariffs on treated mosquito nets. Responding to this lack of political commitment, the Massive Effort is waging a "Drop the Malaria Tax" campaign.
Are you an artist? Do you want your artwork to be seen in 1500 communities around the world? Do you have an image that the HIV/AIDS community can benefit from? If the answer is YES, then participate in the Candlelight Memorial Poster Contest. The Global Health Council is inviting anyone interested to participate in the Candlelight Memorial 2003 Poster Contest. We are asking individuals to submit artwork that addresses this year's theme of remembrance and renewal. The 2003 theme is "Remembering the Cause, Renewing our Commitment,Mobilizing a Global Community". We encourage you to take this contest to your communities and invite everyone to participate. It is a great way to get your community to express their ideas and thoughts about HIV/AIDS through art. All entries will be accepted until November 8, 2002 and we will announce the winner during our annual World AIDS Day event on December 1, 2002.
International organizations, like the Pan American Health Organization (PAHO), in association with the Fogarty International Center of the U.S. National Institutes of Health, the Medical Research Council UK and other parties have initiated a worldwide effort to impulse moral debate around pressing and current issues in the bioethics of biological and biomedical research. This has taken the form, among other expressions, of a series of conferences termed Global Forum on Research Bioethics. The first conference was held in Bethesda, Maryland, in 1999. The second in Bangkok, Thailand, during the year 2000 and the third in The Gambia during November 2001. PAHO will host the Fourth Global Forum in Brasilia, October 2002.
The Global Equity Gauge Alliance is looking for an Assistant Co-ordinator. The Global Equity Gauge Alliance (GEGA) focuses on fairness in health and access to health care. GEGA's 12 country-based Equity Gauge projects, located in South America, Africa, and Asia, monitor inequalities and injustices in the distribution of health and health care resources, and aim to ensure that countries and communities can use this information to make a difference to those with the poorest health and the greatest need. More information on GEGA can be found at www.gega.org.za. The GEGA Secretariat is housed within The Health Systems Trust, a Non-Government Organisation, which is a key role player in facilitating health systems research and development in South Africa.
The International Conference Poverty, Food and Health in Welfare: current issues, future perspectives, which will be held in Lisbon, July 1-4, 2003. The PFH2003 Conference will be the forum to emphasise the role of poverty on food security and health in welfare. The Scientific Programme has to face the challenge of dramatic socio-economic transformations while leading experts will analyse the burden of poverty, hunger and disease and the challenges to social policy in welfare. This Conference offers an outstanding opportunity for the discussion and dissemination of research findings, reviews and theory in all areas of common interest to researchers, health professionals, social scientist, policymakers, educators and students through plenary sessions, workshops, poster sessions and social gatherings. submission of abstracts are welcomed.
For more information about the organisation, its objectives as well as its Zimbabwe AIDS Network is pleased to announce that it is now electronically linked to the world through its new website! For members, upcoming events and publications, please go to http://www.zan.co.zw.